Minimally-invasive surgery equipment

ABSTRACT

A minimally invasive surgical device characterized by comprising: a manipulable handle (2) manipulated by a user inside a body cavity, a treatment part (3) that holds a specific swappable surgical instrument that is inserted into the body cavity and manipulated using the manipulable part, and a linking part (4), provided between the manipulable handle and the treatment part, for disposing the surgical instrument held by the treatment part in a desired orientation at a desired position within the body cavity. The linking part comprising: two or more connecting parts (7a, 7b, 8a, 8b) that are connected in series in the longitudinal direction of the linking part, and form a joint (7, 8) that enables rotation around the longitudinal axis or an axis orthogonal to the longitudinal axis; and a linking part control mechanism that moves the two or more connecting parts toward or away from each other to open or constrict the angle of the joint around the longitudinal axis and/or the angle thereof around an axis orthogonal to the longitudinal axis, thereby disposing the treatment part at the desired position and in the desired orientation within the body cavity.

PRIORITY

The present application is a continuation application to U.S.application Ser. No. 17/593,043, filed on Jan. 25, 2022, which claimspriority to International Patent Application No. PCT/JP2019/019031 filedon May 14, 2019, which claims priority to and the benefit of U.S.Provisional Application No. 62/817,462 filed on Mar. 12, 2019, thedisclosures of which are incorporated herein by reference.

FIELD OF THE INVENTION

The present invention pertains to a surgical device that can be used insurgical procedures to treat lesions within body cavities with minimalinvasiveness to the human body.

PRIOR ART

Recent years have seen increased usage of minimally invasive surgicalprocedures as typified by laparoscopic surgery and thoracoscopicsurgery.

These minimally invasive surgical procedures have the advantage ofinvolving smaller incisions and placing less of a burden upon the bodythan conventional surgical procedures in which large incisions are madein the body and surgical treatment is performed by direct vision. Dailyadvances in minimally invasive surgical procedures are made throughimprovements in the performance of endoscopes and surgical devices, andimprovements in the procedures themselves.

Surgical devices used in common minimally invasive surgical procedureshave a small-diameter insertable part that is inserted into a bodycavity, and a handle for manually manipulating the insertable part. Touse the surgical device, a small incision is first made in the chest,abdomen, etc., of a patient, and a surgical device insertion opening(port) is inserted into the incision. The insertable part of thesurgical device is then inserted into a body cavity through the port.Forceps, scissors, an electric scalpel blade, or the like for performingsurgical treatment is attached to the distal end of the body cavityinsertable part, and controlled using the handle to perform the desiredsurgical procedure.

However, conventional minimally invasive surgical devices are difficultto use in the following cases, thus forcing the selection of a highlyinvasive procedure.

(1) Contact between devices, such as between devices held in both handsor between device and endoscope, or contact with vital organs isunavoidable due to highly constricted working space.

(2) An obstacle such as a vital organ or an adhesion is present betweenthe handle and the target site, especially when there is little abilityto move a vital organ or an adhesion covers a wide area.

(3) The handle and the target cannot be put in the same plane; forexample, the handle and the target site are situated at diametricallyopposite positions on either side of an immovable vital organ.

(4) The vector of the treatment performed on the target is not in thesame plane as the handle and the target structure; one conceivableexample is when an incision is made in the arterial wall of an arteryrunning parallel to a line connecting two surgical device insertionopenings (ports), not in the side closest to the operator, but in theside located 90° away therefrom in the clockwise direction around thecenterline of the artery.

Conventional possible means of circumventing the problems describedabove include increasing the size of the wound in the surface of thebody to increase working space, placing another port, moving a movableorgan within the body cavity, and shifting to open-chest or open-abdomensurgery; however, all of these means increase invasiveness of the body.

Meanwhile, robotic surgeries have been developed in which a surgicalrobot capable of operating with an extremely high degree of freedomwithin bodily cavities is employed to solve the problems described above(for example see Patent Reference 1).

Surgical devices with joints provided in the distal end or shafts toincrease the freedom of the surgical treatment part on the distal end ofthe device have also been developed to make it possible to circumventthe problems described above using conventional surgical devices (forexample, see Patent Reference 2).

However, the conventional surgical robots disclosed in Patent Reference1, while being increasingly widespread and having the advantages ofextremely high freedom of operation and the ability to perform delicatemovements, all have extremely complicated mechanisms and are quiteexpensive. Therefore, such robots cannot be easily adopted due toequipment-related or financial considerations. Moreover, it is difficultto obtain biofeedback, primarily tactile feedback, from a surgicaltreatment part equipped on a robot at current levels of technology, anda single surgical procedure incurs high material costs.

Surgical devices such as disclosed in Patent Reference 2 have shaftsthat are bendable or flexible, and enable surgical treatment parts toreach their targets through rolling movement of the entire device fromthe shaft onward. However, it is difficult to deform the shaft in threedimensions, or engage in extreme bending of 90° or more from the centralaxis of the handle, with the mechanism of Reference 2. Some underlyingfactors of this difficulty are the emphasis placed on the shaft beingmanipulable with one hand and being small in diameter in conventionalsurgical devices, and the fact that, in such conditions, free triaxialdeformation and extreme bending of the shaft makes it impossible tomaintain shaft rigidity and drastically complicates the structure of thedevice.

PRIOR ART REFERENCE

-   Patent Reference 1: JP 2012-143589 A-   Patent Reference 2: JP 2017-189571 A

BRIEF SUMMARY OF THE INVENTION Problem to be Solved by the Invention

The present invention was conceived in view of the problems describedabove, and has an object of providing a surgical device that is capableof bending and rotation in multiple directions while maintaining shaftrigidity and without increased structural complexity, and is capable ofcontributing a high degree of freedom to a distal end operating partcomprising a surgical treatment part through anywhere from slight toextreme bending, or by maintaining complex three-dimensional shapes.

Means for Solving the Problem

In order to solve the problem described above, the present inventionprovides a first aspect as follows.

-   -   (1) A minimally invasive surgical device characterized by        comprising:        -   a manipulable handle manipulated by a user inside a body            cavity, a treatment part that holds a specific swappable            surgical instrument that is inserted into the body cavity            and manipulated using the manipulable part, and a linking            part, provided between the manipulable handle and the            treatment part, for disposing the surgical instrument held            by the treatment part in a desired orientation at a desired            position within the body cavity;        -   the linking part comprising:            -   two or more connecting parts that are connected in                series in the longitudinal direction of the linking                part, and form a joint that enables rotation around the                longitudinal axis or an axis orthogonal to the                longitudinal axis; and            -   a linking part control mechanism that moves the two or                more connecting parts toward or away from each other to                open or constrict the angle of the joint around the                longitudinal axis and/or the angle thereof around an                axis orthogonal to the longitudinal axis, thereby                disposing the treatment part at the desired position and                in the desired orientation within the body cavity.    -   (2) The minimally invasive surgical device according to (1),        wherein:        -   the linking part control mechanism comprises:        -   a linking part control slider that is capable of sliding in            the longitudinal direction of the manipulable handle, and            the movement of which can be locked at a specific position;            and        -   a flexible shaft member that is passed through the interior            of the entirety of the linking part, and is affixed at one            end to the treatment part and at another end to the linking            part manipulation slider; and        -   the linking part control slider is slid in the longitudinal            direction of the manipulable handle to open or constrict the            angle of the joint.    -   (3) The minimally invasive surgical device according to (1),        wherein:        -   the linking part comprises a first joint that permits            rotation around the longitudinal axis and/or a second joint            that permits rotation around an axis orthogonal to the            longitudinal axis.    -   (4) The minimally invasive surgical device according to (3),        wherein:        -   the connecting parts comprise recessed parts and projecting            parts that face and are capable of engaging with each other,            and the recessed parts and the projecting parts are            disengaged when released by the angle control part, and            engaged at a fixed angle when constricted thereby.    -   (5) The minimally invasive surgical device according to (3),        wherein:        -   the connecting parts have a stopper mechanism that restricts            the angle of rotation thereof around the axis orthogonal to            the longitudinal axis.    -   (6) The minimally invasive surgical device according to (5),        wherein:        -   the restricted angle of rotation is ±30°.    -   (7) The minimally invasive surgical device according to (6),        wherein:        -   the linking part comprises a number of joints such that a            90°-180° bent shape can be maintained by a plurality of            joints.    -   (8) The minimally invasive surgical device according to (1),        wherein:        -   the linking part control slider is attached to a slide            guider provided on the manipulable handle.    -   (9) The minimally invasive surgical device according to (8),        wherein:        -   the shaft member is a tension-transmitting rod or wire; and        -   the linking part control slider is a tension slider for            adjusting the tension of the tension-transmitting rod.    -   (10) The minimally invasive surgical device according to (9),        wherein:        -   the tension of the tension-transmitting rod or wire is            adjusted by operating the linking part control slider            parallel to the longitudinal direction of the handle.    -   (11) The minimally invasive surgical device according to (1),        further comprising:        -   a surgical-treatment-part-controlling flexible shaft member            that is connected at one end to the surgical treatment part,            and the other end of which passed through the insides of the            connecting parts and extends toward the handle; and        -   a surgical treatment part actuation slider that is attached            to the handle in a state of connection to the other end of            the surgical-treatment-part-controlling flexible shaft            member.    -   (12) The minimally invasive surgical device according to (11),        wherein:        -   the surgical treatment part actuation slider is attached to            the linking part control slider, and is movable with respect            to the linking part control slider.

Other characteristics of the present invention will be made apparent inthe descriptions of the embodiment of the present invention describedbelow.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a schematic illustration of a minimally invasive surgicaldevice according to an embodiment of the present invention.

FIG. 2 is a schematic illustration showing the operation of the same.

FIG. 3 is a schematic illustration of joint members in the same.

FIG. 4 is a schematic illustration of a first joint member in the same.

FIG. 5 is a schematic illustration of a second joint member in the same.

FIG. 6 is a schematic illustration of joint members in the same beingmanipulated.

FIG. 7 is a schematic illustration showing the movement of first andsecond joints in the same.

FIG. 8 is a schematic illustration of a slide guide.

FIG. 9 is a schematic illustration of the configuration of a slider inthe same.

FIG. 10 is a schematic illustration of a manipulable handle of the same.

FIG. 11 is a schematic illustration demonstrating the manipulation of amanipulable handle and a ring of a slider.

BEST MODE FOR EMBODYING THE INVENTION

An embodiment of the present invention will now be described withreference to the drawings.

(Overall Configuration)

FIG. 1 is an overall schematic illustration of a minimally invasivesurgical device 1 according to this embodiment.

Broadly speaking, the surgical device 1 comprises a manipulable handle 2for a user to manipulate the surgical device outside a body cavity, atreatment part 3 that holds a specific surgical instrument 5 that isinserted into a body cavity of a patient (not shown) and manipulatedusing the manipulable handle 2, and a linking part 4 that links themanipulable handle 2 and the treatment part 3 and disposes the surgicalinstrument 5 held by the treatment part 3 at a specific position withinthe body cavity.

FIGS. 1 and 2 depict states in which the linking part 4 is displaced todisplace the position and direction of the treatment part 3 (surgicalinstrument 5) in three dimensions, i.e., in the XYZ directions, and in arotational direction θ.

(Configuration of Linking Part)

The present invention is characterized by the configuration of thelinking part 4 that realizes this three-dimensional displacement andpositioning of the surgical instrument 5; this configuration will bedescribed in detail below.

As shown in FIG. 1 , the linking part 4 comprises two types of jointmembers 7, 8 disposed in a series in the longitudinal direction of thelinking part 4, a plurality of the joint members being alternatelylinked in the order 7, 8, 7, 8, 7, 8, with joints being formedtherebetween.

FIG. 3 is a magnified view of the link relationship between the twotypes of joint members (first joint member 7, second joint member 8),FIGS. 4(a)-(d) are a head-on view, top-down view, and side views of thefirst joint member 7, and FIGS. 5(a)-(d) are a head-on view, top-downview, and side views of the second joint member 8.

First, as shown by the link relationship in FIG. 3 , the first jointmember 7 and the second joint member 8 respectively comprise innerinsertion parts 7 a, 8 a that are inserted into one of the jointmembers, and outer insertion parts 7 b, 8 b that receive the insertedinner insertion parts 7 a, 8 a of the counterpart member. The innerinsertion parts 7 a, 8 a and outer insertion parts 7 b, 8 b respectivelyconstitute the connecting parts of the present invention, and form thejoints of the linking part 4 when connected.

As shown in FIG. 4 , the outer insertion part 7 b of the first jointmember 7 comprises a cylindrical-shaped retaining hole 7 c for retaininga first linking pin 9 in the diameter direction. Meanwhile, as shown inFIG. 5 , the inner insertion part 8 a of the second joint member 8inserted into the outer insertion part 7 b of the first joint member 7has a columnar shape that conforms to the inner diameter of the outerinsertion part 7 b of the first joint member 7, and comprises anengagement hole 8 c that engages with the first linking pin 9, which isinserted into the outer insertion part 7 b of the first joint member 7.The engagement hole 8 c comprises one set of recessed parts 8 d alongthe diameter direction, the recessed parts being provided at 30°intervals in the circumferential direction, and a linking passage 8 ethat links adjacent recessed parts 8 d. The recessed parts 8 d areconfigured to engage with the first linking pin 9 when the first andsecond joint members 7, 8 are actuated toward each other (in thedirection indicated by the arrows in FIG. 3 ). The linking passage 8 eis configured to disengage the first linking pin 9 and the recessed part8 d and permit the linking pin 9 to move between the recessed parts 8 dwhen the first and second joint members 7, 8 are actuated away from eachother (in the direction opposite that indicated by the arrows in FIG. 3).

Meanwhile, as shown in FIG. 5 , the second joint member 8 comprises apair of facing arms 8 f, 8 f that extend in the axial direction as theouter insertion part 8 b. The distal ends of the pair of arms 8 fcomprises tapered parts 8 g that engage with a guide face 7 d and sunkenparts 7 e of the first joint member 7, to be described below, andsliding surfaces 8 h that slide along the guide face 7 d. The engagementholes 8 c, which retain a second linking pin 10 that is suspended in adirection orthogonal to the central axis of the second joint member 8,are provided in the arms 8 f.

As shown in FIG. 4 , the first joint member 7 comprises a guide face 7 dthat contacts the arms 8 f of the second joint member 8 and guides thearms 8 f around the second linking pin 10 (in the direction indicated byarrow B) as the sliding faces 8 h of the arms 8 f slide therealong, andfirst and second sunken parts 7 e, 7 e′ that engage with distal ends 8 gof the arms 8 f to fix the angle of rotation.

The inner insertion part 7 a of the first joint member 7 comprises acenter guide 7 f that is inserted between the pair of arms 8 fconstituting the outer insertion part 8 b of the second joint member 8,and the center guide 7 f comprises a retaining hole 7 g that retains thesecond linking pin 10 suspended between the pair of arms 8 f.

The retaining hole 7 g comprises first and second recessed parts 7 h, 7h′ that retain the second linking pin 10 attached to the second jointmember 8 at positions at which the tapered parts 8 g engage with thefirst sunken part 7 e and the second sunken part 7 e′, respectively.

(Operation of linking part) FIGS. 6(a) and (b) are schematicillustrations of the first and second joint members 7, 8 in an assembledform, and displacement thereof in the front-back direction.

As described above, with the central axes of the first and second jointmembers 7, 8 in alignment, the inner insertion parts 7 a, 8 a of onemember are inserted into the outer insertion parts 7 b, 8 b of the othermember to join the two, and inextricably linked by the first and secondlinking pins 9, 10. A linking part 4 comprising a plurality of joints isthus formed.

Meanwhile, a slide guide 12 and a slider 13 that can be slid along theslide guide 12 and positioned in the axial direction are attached to themanipulable handle 2. One end of a first actuation wire 14 shown in thedrawing is affixed to the slider 13. The other end of the firstactuation wire 14 passes through the linked first and second jointmembers 7, 8, as shown by the arrow in the drawing, and affixed to therear end of the treatment part 3.

In this embodiment, a distal end 12 a of the slide guide 12 is identicalin shape to the outer insertion part 8 b of the second joint member 8,and is linked by the second linking pin 10 to the rear end of thelinking part 4 (the inner insertion part 7 a of the first joint member7).

A rear end 3 a of the treatment part 3 is identical in shape to theinner insertion part 8 a of the second joint member 8, and is linked bythe first linking pin 9 to the distal end of the linking part 4.

The length to which the first actuation wire 14 is extended from theslider 13 can be controlled by adjusting the position at which theslider 13 and the first actuation wire 14 are joined. FIG. 6(a) depictsa state in which the slider 13 has been moved as far toward the distalend as possible, and FIG. 6(b) a state in which the slider 13 has beenmoved as far to the rear as possible.

The length to which the first actuation wire 14 is extended is adjustedto establish the gaps labeled 16, 17 in the drawing between the firstand second joint members 7, 8 (the connecting parts of the presentinvention) in the state shown in FIG. 6(a), and to close the gaps 16, 17between the first and second joint members 7, 8 in the state shown inFIG. 6(b).

Specifically, as shown in FIG. 3 , a flange 8 i is formed on the secondjoint member 8 between the inner insertion part 8 a and the outerinsertion part 8 b, and, in the state shown in FIG. 6(a), the flanges 8i of the second joint members 8 and end surfaces 7 i of the outerinsertion parts 7 b of the first joint members 7 are separated from eachother to form the first gaps 16. In this state, the second joint members8 are capable of rotating around their central axes, as indicated by Ain FIGS. 3 and 5 .

The slider 13 is moved rearward to create the state shown in FIG. 6(b),and the end surfaces 7 i of the outer insertion parts 7 b of the firstjoint members 7 are brought into contact with the flanges 8 i of thesecond joint members 8 to close the first gaps 16, thereby restrictingfurther axial movement of the joint members 7, 8, and the first linkingpins 9 are engaged with the recessed parts 8 d of the second jointmembers 8, thus also restricting rotating around the central axis.

The second gaps 17 shown in FIG. 6(a) are gaps between the sunken parts7 e formed in the first joint members 7 and the tapered parts 8 g of thesecond joint members 8, and the first and second joint members 7, 8 arecapable of rotating around each other in the direction indicated byarrow B in FIG. 3 when these second gaps 17 are present.

Sliding the slider 13 rearward to the state shown in FIG. 6(b) bringsthe second sunken parts 7 e formed in the first joint members 7 intocontact with the tapered parts 8 g of the second joint members 8,resulting in a gap-free state. As a result, the first and second jointmembers are locked to each other, thereby restricting the rotation ofeach other.

This movement between the first and second joint members 7, 8 will bedescribed below in greater detail with reference to FIG. 7 .

In FIG. 7 , an isolated section constituted by first joint members 7, 7attached to the front and rear of a single second joint member 8 will bedescribed.

FIGS. 7(a) and (b) depict the slider 13 positioned toward the distal end(the state shown in FIG. 6(a)), and FIG. 7(c) depicts the slider 13having been moved toward the rear end (the state shown in FIG. 6(b)).

In the state shown in FIG. 7(a), the first joint member 7 attached tothe front side of the second joint member 8 is capable of rotatingaround an axis orthogonal to the central axis, as indicated by arrow B.The first joint member 7 attached to the rear side of the second jointmember 8 is capable of rotating around the central axis, as indicated byarrow A.

Simply sliding the slider 13 rearward from this state to close the gaps16, 17 as described above yields the state shown in FIG. 6(b).

Meanwhile, FIG. 7(b) depicts a state in which the rear first jointmember 7 has been rotated 30° around the central axis, and the frontfirst joint member 7 has been rotated 30° around an axis orthogonal tothe central axis.

In other words, the front first joint member 7 is capable of rotating tobe positioned at two angles (0° and 30°) (direction indicated by arrowB) corresponding to the positions of the first and second sunken parts 7e, 7 e′. The rear first joint member 7 is capable of rotating 0°, −30°,and +30° clockwise (the direction indicated by arrow A) incorrespondence with the position of the recessed part 8 d.

FIG. 7(c) depicts a state in which the slider 13 has been moved rearwardfrom the state shown in FIG. 7(b). In the configuration of this example,the orientations of the first and second joint members 7, 8 areself-aligningly adjusted and fixed at a specific angle as the slider 13is moved. In other words, the sliding faces 8 h of the arms 8 f of thesecond joint member 8 and the guide face 7 d of the first joint member 7slide between the first joint member 7 in front and the second jointmember 8 in the center, and the tapered parts 8 g thereof are guided toand engage with the sunken part 7 e, thereby positioning the jointmembers. As a result, even if the angle between the first joint member 7and the second joint member 8 deviates from the initial 30° or 0°(untilted), the members are guided by the sliding faces 8 h and theguide parts 7 d and are positioned and fixed at 30° or 0° when thesecond gap 17 is absent.

At this time, an upper edge 7 j of the first joint member 7 and an upperedge 8 j of the second linking pin 10 touch each other, and the secondlinking pin 10 engages with the recessed part 7 h in the retaining hole7 g. As a result, the first joint member 7 and second joint member 8 areultimately positioned and retained at three points, and the orientationsthereof are kept in a highly rigid state even when tilted.

Meanwhile, the rear first joint member 7 and the second joint member 8are positioned by the first linking pin 9 being guided to and engagingwith one of the recessed parts 8 d as the slider 13 is moved rearward.Thus, when the gaps 16, 17 are absent, the angles of the first andsecond joint members 7, 8 are fixed at 30°, 0°, and −30° in theirrespective rotational directions.

In this configuration, the first and second joint members 7, 8 arecapable of respectively rotating around the central axis A and the axisB orthogonal to the central axis when the slider 13 is positioned to thefront as shown in FIG. 6(a), thereby making it possible to freely deformthe linking part 4 in the three-dimensional XYZ directions and therotational direction θ around the central axis, as shown in FIGS. 1 and2 .

In other words, the orientation of the first and second joint members 7,8 can be freely displaced in the state shown in FIG. 6(a), but thedegree of displacement is restricted so that the linking pins 9, 10 donot disengage.

When the slider 13 is moved rearward from the state shown in FIG. 6(a)to the state shown in FIG. 6(b), the orientations of the first andsecond joint members 7, 8 are self-aligningly fixed at a specific angleas the gaps therebetween close, thereby fixing the shape of the freelydeformed linking part 4.

Because the plurality of first and second joint members 7, 8 making upthe linking part 4 are capable of being moved along the first actuationwire 14, it is possible to fix the rotational angles of some first andsecond joint members 7, 8 while adjusting the rotational angles of otherfirst and second joint members 7, 8 to manifest a desiredthree-dimensional shape over the process of moving the slider 13. It isthus possible to set the general overall shape before moving the slider13, then move the slider 13 to set the final shape.

(Configuration of Slider)

Next, the configuration and operation of the slider 13 will be describedin more detail.

FIG. 8 is a schematic view of the slide guide 12, and FIGS. 9(a), (b)are schematic views of the configuration of the slider 13 attached tothe slide guide 12.

The slide guide 12 comprises a bore 12 b provided along its centralaxis, a slit 12 c that is provided in the bore 12 b and opens onto thesurface of the slide guide 12, and a plurality of cut-outs 12 d formedin the slit 12 c at specific intervals in the axial direction.

Meanwhile, the slider 13, as shown in FIG. 9(a), comprises a body 13 athat is inserted in the bore 12 b of the slide guide 12 (not shown inFIG. 9(a)) and capable of moving along the slide guide 12, and amanipulable handle 13 b that is fitted on the outside of the slide guide12 and affixed to the body 13 a.

FIG. 9(b) depicts the body 13 a alone. As seen in the drawing, the firstactuation wire 14 for controlling the orientation of the linking part 4as described above is affixed by a screw 15 to the front end of the body13 a. A separate second actuation wire 18 for controlling the surgicalinstrument 5 is inserted into the body 13 a, and the second actuationwire 18 is attached to a surgical-instrument-controlling slider 19attached to the body 13 a so as to be capable of freely sliding forwardand backward. Body projections 20 projecting outward in the axialdirection are provided on the rear end of the body 13 a.

To assemble the slider 13, the body 13 a is first inserted into the bore12 b from one end of the slide guide 12, after which the manipulablehandle 13 b is fitted over the outside of the slide guide 12 andcombined with the body 13 a.

FIG. 10 is a perspective view of the manipulable handle 13 b. Beforeassembly, a front end 21 of the slider is removed to open one end of aslit 22, and the handle is combined with the body 13 a so that theslider 19 enters the slit 22. Cylindrical spaces 23 and a projection 24projecting inward in the axial direction are provided inside themanipulable handle 13 b. The projections 20 on the slider body 13 a fitwithin the spaces 23 inside the handle, allowing the manipulable handle13 b to rotate around the central axis of the slide guide 12. Theprojection 24 inside the handle also rotates as the manipulable handle13 b rotates, and the projection 24 engages with the cut-outs 12 d inthe slide guide to immobilize the handle 13 with respect to thelongitudinal direction.

Next, the ring-shaped member labeled 13 c in FIG. 9(a) is attached toboth ends 19 a, 19 b of the surgical-instrument-controlling slider 19.The ring 13 c is a handle for manipulating thesurgical-instrument-controlling slider 19.

Once the body 13 a, manipulable handle 13 b, and ring 13 c have beencombined in this way, the front end 21 of the slider is fixed in placeto close the end of the slit 22.

The manipulable handle 13 b engages with the body projections 20 in thespaces 23 inside the handle, and the manipulable handle 13 b can bemoved in the axial direction to move the body 13 a in the samedirection. Meanwhile, the manipulable handle 13 b is capable of rotatingaround the central axis, but is restricted from rotating around thecentral axis of the body 13 a by the body projections 20 fit into theslit 12 c of the slide guide.

(Operation of slider) Next, a method of manipulating the handle will bedescribed with reference to FIG. 11 .

FIG. 11(a), as described above, depicts a process of pulling the slider13 rearward along the slide guide 12 while adjusting the rotationalangles of the other first and second joint members 7, 8 to set the shapeof the linking part 4 to a desired three-dimensional shape.

Once the linking part 4 has been successfully set to the desired shape,the manipulable handle 13 b of the slider 13 is rotated to a specificangle around the axis, as shown in FIG. 11(b). As a result, theprojection 24 (not shown) in the manipulable handle can engaged with thecut-outs 12 d to immobilize the slider 13.

Next, FIGS. 11(c) and (d) depict the surgical instrument 5 beingmanipulated by manipulating the ring 13 c to move the ring 13 c relativeto the slider 13. In this embodiment, the surgical instrument 5 is apair of scissors (shown in FIG. 1 ), and the ring 13 c can be movedforward as shown in FIG. 11(c) actuate the second actuation wire 18forward and open the scissors. The ring 13 c can also be moved rearwardas shown in FIG. 11(d) to close the scissors via the second actuationwire 18.

In accordance with the configuration described above, the linking part 4can be deformed in three dimensions, making it possible to obtain asurgical device that is capable, in particular, of extreme bending of90° or more with respect to the central axis of the manipulable handle2.

The present invention is not limited to the embodiment described above,and various modifications may be made thereto to the extent that they donot depart from the gist of the invention.

For example, while the number of joints formed by the first and secondjoint members 7, 8 is about 10 in the embodiment described above, thisnumber can be freely set according to the required degree of freedom inand amount of three-dimensional deformation.

The expression “two or more connecting parts” in the claims refers tothe “inner insertion part of one joint” and the “outer insertion part ofanother joint”, and a pair of inner and outer insertion parts forms onerelatively rotating joint. For example, in the example shown in FIG.6(a), if the joint members 7, 8 were removed and the distal end 12 a ofthe slide guide 12 were linked to the rear end 3 a of the directtreatment part 3, the slide guide 12 and treatment part 3 would belinked by the “two or more linking parts” so as to be capable of beingrotated and position around the linking pin, thereby forming a singlejoint. The present invention would be embodied even without the jointmembers 7, 8 as in the embodiment described above as long as there is atleast one joint.

While the angles of rotation of the joints around the longitudinal axisand an axis orthogonal to the longitudinal axis is ±30° in theembodiment described above, the present invention is not limitedthereto; for example, angles of ±40° can also be set.

By setting the number and possible angles of rotation of the jointmembers and joining parts in this way, it is possible to alter the rangeof motion of the joints according to the preferences of the surgeon orthe specifics of the surgical procedure being performed.

For example, if the angle of rotation of joints formed by joining parts7 b and 8 a around the longitudinal axis is ±30°, the range of motionwill be ±60° if two joints are used, and ±180° if six are used. If noteven one such joint is used, i.e., if only joints formed by joiningparts 7 a and 8 b are used, rotation around the longitudinal axis willbe impossible; however, such an arrangement is of course acceptable.

Meanwhile, if the angle of rotation of joints formed by joining parts 7a and 8 b around an axis orthogonal to the longitudinal axis is ±30°,the range of motion will be ±60° if two joints are used, and ±180° ifsix are used. If not even one such joint is used, i.e., if only jointsformed by joining parts 7 b and 8 a are used, rotation around axesorthogonal to the longitudinal axis will be impossible; however, such anarrangement is of course acceptable.

While a surgical treatment part capable of articulating motion, such asscissors, is used as an example of the surgical instrument in theembodiment described above, the present invention is not limited tosuch. For example, this surgical instrument can be swapped with atreatment part for which articulating motion is not required, such as ascalpel or retractor. In such cases, the second actuation wire 18connected to the treatment part 3, and the handle actuating the wire,are unnecessary. In such cases, the ring 13 c can be removed, or themanipulable handle can be replaced with one not provided with a ring inthe first place.

REFERENCE NUMBERS

-   -   1: Minimally invasive surgical device    -   2: Manipulable handle    -   3: Treatment part    -   3 a: Rear end    -   4: Linking part    -   5: Surgical instrument    -   7: First joint member    -   7 a: Inner insertion part (one of the connecting parts of the        present invention)    -   7 b: Outer insertion part (one of the connecting parts of the        present invention)    -   7 c: Retaining hole    -   7 d: Guide face    -   7 e: First sunken part    -   7 e′: Second sunken part    -   7 f: Center guide    -   7 g: Retaining hole    -   7 h: Recessed part    -   7 i: End surface    -   7 j: Upper edge    -   8: Second joint member    -   8 a: Inner insertion part (one of the connecting parts of the        present invention)    -   8 b: Outer insertion part (one of the connecting parts of the        present invention)    -   8 c: Engagement hole    -   8 d: Recessed part    -   8 e: Linking passage    -   8 f: Arm    -   8 g: Tapered part    -   8 h: Sliding face    -   8 i: Flange    -   8 j: Upper edge    -   9: First linking pin    -   10: Second linking pin    -   12: Slide guide    -   12 a: Distal end    -   12 b: Bore    -   12 c: Slit    -   12 d: Cut-out    -   13: Slider    -   13 a: Body    -   13 b: Manipulable handle    -   13 c: Ring    -   14: First actuation wire    -   15: Screw    -   16: First gap    -   17: Second gap    -   18: Second actuation wire    -   19: Surgical instrument control slider    -   19 a: One end    -   19 b: One end    -   20: Body projection    -   21: Slider front end    -   22: Slit    -   23: Space inside handle    -   24: Projection inside handle

1. A minimally invasive surgical device characterized by comprising: amanipulable handle manipulated by a user inside a body cavity, atreatment part that holds a specific swappable surgical instrument thatis inserted into the body cavity and manipulated using the manipulablepart, and a linking part, provided between the manipulable handle andthe treatment part, for disposing the surgical instrument held by thetreatment part in a desired orientation at a desired position within thebody cavity; the linking part comprising: two or more connecting partsthat are connected in series in the longitudinal direction of thelinking part, and form a joint that enables rotation around thelongitudinal axis or an axis orthogonal to the longitudinal axis; and alinking part control mechanism that moves the two or more connectingparts toward or away from each other to open or constrict the angle ofthe joint around the longitudinal axis and/or the angle thereof aroundan axis orthogonal to the longitudinal axis, thereby disposing thetreatment part at the desired position and in the desired orientationwithin the body cavity.
 2. The minimally invasive surgical deviceaccording to claim 1, wherein: the linking part control mechanismcomprises: a linking part control slider that is capable of sliding inthe longitudinal direction of the manipulable handle, and the movementof which can be locked at a specific position; and a flexible shaftmember that is passed through the interior of the entirety of thelinking part, and is affixed at one end to the treatment part and atanother end to the linking part manipulation slider; and the linkingpart control slider is slid in the longitudinal direction of themanipulable handle to open or constrict the angle of the joint.
 3. Theminimally invasive surgical device according to claim 1, wherein: thelinking part comprises a first joint that permits rotation around thelongitudinal axis and/or a second joint that permits rotation around anaxis orthogonal to the longitudinal axis.
 4. The minimally invasivesurgical device according to claim 3, wherein: the connecting partscomprise recessed parts and projecting parts that face and are capableof engaging with each other, and the recessed parts and the projectingparts are disengaged when released by the angle control part, andengaged at a fixed angle when constricted thereby.
 5. The minimallyinvasive surgical device according to claim 3, wherein: the connectingparts have a stopper mechanism that restricts the angle of rotationthereof around the axis orthogonal to the longitudinal axis.
 6. Theminimally invasive surgical device according to claim 5, wherein: therestricted angle of rotation is ±30°.
 7. The minimally invasive surgicaldevice according to claim 6, wherein: the linking part comprises anumber of joints such that a 90°-180° bent shape can be maintained by aplurality of joints.
 8. The minimally invasive surgical device accordingto claim 1, wherein: the linking part control slider is attached to aslide guider provided on the manipulable handle.
 9. The minimallyinvasive surgical device according to claim 8, wherein: the shaft memberis a tension-transmitting rod or wire; and the linking part controlslider is a tension slider for adjusting the tension of thetension-transmitting rod.
 10. The minimally invasive surgical deviceaccording to claim 9, wherein: the tension of the tension-transmittingrod or wire is adjusted by operating the linking part control sliderparallel to the longitudinal direction of the handle.
 11. The minimallyinvasive surgical device according to claim 1, wherein: furthercomprising: a surgical-treatment-part-controlling flexible shaft memberthat is connected at one end to the surgical treatment part, and theother end of which passed through the insides of the connecting partsand extends toward the handle; and a surgical treatment part actuationslider that is attached to the handle in a state of connection to theother end of the surgical-treatment-part-controlling flexible shaftmember.
 12. The minimally invasive surgical device according to claim11, wherein: the surgical treatment part actuation slider is attached tothe linking part control slider, and is movable with respect to thelinking part control slider.